By Kurt Erickson
Calling painkiller abuse a "modern plague," Missouri Gov. Eric Greitens sidestepped the Legislature Monday to create a prescription drug monitoring program on his own.
In issuing an executive order to bring Missouri in line with the rest of the nation, the Republican governor launched a weeklong series of events designed to focus on opioid abuse and drug trafficking.
Greitens said he was moving forward on the database without the GOP-led House and Senate's endorsement because opioid abuse must be addressed.
"There are too many families that have had to deal with this," Greitens said during an event at St. Louis-based Express Scripts, a pharmacy benefits manager. "We have to look this problem square in the eye."
Monitoring programs underway in other states and in more than a dozen Missouri counties keep track of every time a patient is prescribed an opioid painkiller. Hydrocodone, sometimes sold under the brand name Vicodin or Norco, and oxycodone, which is often sold as OxyContin or Percocet, are some of the most frequently prescribed opioids.
The programs monitor the prescription of these and other opioids. Doctors can see if their patients are receiving painkillers from other doctors too, and can make decisions about adjusting their treatment options or getting help for an addiction.
Under Greitens' plan, the Department of Health and Senior services will enter into contracts with Express Scripts and other pharmacy benefit management companies to analyze doctor and pharmacy prescription and dispensing data for schedule II through IV controlled substances.
The agency will use the information to identify activity indicating that controlled substances are being inappropriately prescribed, dispensed, or obtained.
Greitens said he wants the program to target "pill mills" that pump out prescription drugs at "dangerous and unlawful levels."
The executive order notes that "Prescription and dispensation information received by DHSS shall be confidential."
The estimated start-up cost of the program is $250,000, said Greitens' health chief Randall Williams.
St. Louis County Executive Steve Stenger issued a statement saying the county-level program, which covers 58 percent of Missouri's population, will continue to operate "with the hope that whatever the governor proposes does nothing to hinder our progress."
Missouri is the only state in the country without a way to track opioid abuse. A measure that would have created a database failed to win approval before the legislative session adjourned in May.
The Senate approved a prescription drug monitoring program that attempted to address privacy concerns. It would have required patients' medical information be purged after 180 days and included restrictions on what kinds of drugs can be tracked.
But some members of the House balked, saying the data should be kept for a longer period of time. They also said the Senate version would allow highly addictive drugs such as Adderall to go unpoliced.
The lead sponsor of the legislation in the House, Rep. Holly Rehder, R-Cape Girardeau, did not immediately return messages Monday. Sen. Dave Schatz, R-Sullivan, who sponsored legislation in the Senate, had not yet been briefed on the order.
The governor's manuever rankled some lawmakers. On Twitter, Rep. Shamed Dogan, R-Ballwin, wrote, "Governing by executive order because you couldn't get a bill passed was wrong under Obama and it's wrong today."
Greitens has issued 18 executive orders since taking office in January.
In a release, U.S. Department of Health and Human Services Secretary Tom Price praised the governor.
"I commend Missouri Governor Eric Greitens for taking a strong step in fighting the opioid epidemic by joining other states in establishing a Prescription Drug Monitoring Program," Price noted.
The announcement marks the first of a week's worth of focus on drugs and drug abuse by the first-year governor. On Tuesday he will be in St. Louis discussing ways to prevent overdose deaths. He will be in Cape Girardeau and Springfield later in the week to outline plans for combating drug traffickers and treating addiction in rural Missouri.
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